Provider Demographics
NPI:1902247760
Name:OETKEN, ALEXIA MURRAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALEXIA
Middle Name:MURRAY
Last Name:OETKEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 ASBURY RD
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002-2892
Mailing Address - Country:US
Mailing Address - Phone:563-556-2711
Mailing Address - Fax:563-556-8017
Practice Address - Street 1:4200 ASBURY RD
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52002-2892
Practice Address - Country:US
Practice Address - Phone:563-556-2711
Practice Address - Fax:563-556-8017
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADDS-09047122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist